Simultaneous Pancreas-Kidney Transplantation: Five-Year Results From a Single Center
| Autor: | António Cabrita, A Ribeiro, F. Oliveira, Jorge Dores, António Castro Henriques, R. Seca, S Esteves, Raquel Almeida, S. Pedroso, R. Pereira, A.M. Sarmento, La Salete Martins, M Amil, A Lhamas, Leonídeo Dias, Manuel Teixeira, T. Coelho |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Urinary system medicine.medical_treatment Single Center chemistry.chemical_compound Diabetes mellitus medicine Humans Diabetic Nephropathies Survivors Dialysis Retrospective Studies Transplantation Kidney Creatinine business.industry Graft Survival Middle Aged medicine.disease Kidney Transplantation Survival Analysis Thrombosis Surgery Diabetes Mellitus Type 1 medicine.anatomical_structure chemistry Kidney Failure Chronic Female Pancreas Transplantation business Immunosuppressive Agents |
| Zdroj: | Transplantation Proceedings. 38:1929-1932 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2006.06.089 |
| Popis: | We report the 5-year results of our simultaneous pancreas-kidney transplantation (SPKT) program, started on May 2, 2000. Forty-two SPKT were performed on 42 type I diabetic patients with chronic renal failure. The procedure was performed with enteric diversion and vascular anastomosis to the iliac vessels. Immunosuppressive protocol included antithymocyte globulin, tacrolimus, mycophenolate mofetil, and steroids. The 24 women and 18 men had a mean age of 33.5 ± 6.3 years and mean 22.8 ± 14.2 years time of diabetes evolution. Forty patients had been on dialysis for 34.3 ± 24.1 months, and two were preemptive transplantations. Acute rejection episodes were treated in eight patients (19.1%): in three cases they affected both organs; in two only the kidney was affected; and the other three were pancreas graft rejections. The incidence of postoperative complications requiring re-operation was 42.9%, mostly pancreas graft related. Two patients died, one due to cardiovascular disease; the other was transplant related. Three kidney grafts were lost, and the causes were immunologic, thrombosis, and patient death. Pancreas graft loss occurred in seven patients: thrombosis (n = 3); infection (n = 3); immunologic (n = 1). The patients with surviving grafts were doing well, with normal kidney and pancreas function: serum creatinine = 0.89 ± 0.15 mg/dL; fasting blood glucose = 79 ± 16 mg/dL; HbA1c = 4.7 ± 1.1%. The 1-year patient, kidney, and pancreas survival rates were 97.3%, 94.6%, and 83.8% and 5-year values, 91.7%, 89.2%, and 78.7%, respectively. In conclusion, these results are similar to the most recent UNOS/IPTR reports, leading us to consider our experience with SPKT very positive. |
| Databáze: | OpenAIRE |
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